Non-invasive detection of multinucleated giant cells in the conjunctiva of patients with sarcoidosis by in-vivo confocal microscopy.
Non-invasive detection of multinucleated giant cells in the conjunctiva of patients with sarcoidosis by in-vivo confocal microscopy.
复制标题
体内共聚焦显微镜无创检测结节病患者结膜中的多核巨细胞。
DOI：
10.1080/09273940600826471
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发表时间：
2006
影响因子：
3.3
通讯作者：
Rosenbaum,JamesT
中科院分区：
文献类型：
--
作者：
Wertheim,MichaelS;Mathers,WilliamD;Lim,Lyndell;Watkins,AngelaS;Mackensen,Friederike;O'Malley,JeanP;Rosenbaum,JamesT
目的：探讨使用体内共聚焦显微镜（IVCM）作为一个潜在的非侵入性的诊断结节病的cardioides.Methods：结膜成像共聚焦显微镜在10例结节病和27例对照组。我们利用ASL-1000扫描共聚焦显微镜（Advanced Scanning Ltd.，New Orleans，LA）和Confoscan 3（Nidek Co. Ltd.，日本Gamagori）。两名戴面罩的观察者回顾了这些受试者结膜的体内共焦图像。一名设盲的观察者在审查共焦图像方面有经验。在共聚焦显微镜下观察到的肉芽肿性炎症中最显著和最明显的特征是多核巨细胞（MGCs）的存在。结果：扫描的未掩蔽观察显示10例结节病患者中有6例有MGCs，对照组中无MGCs。一位经验丰富的盲态观察者在10例结节病患者中的5例中发现了MGCs，并且没有假阳性结果（Fisher精确检验，p = 0.001;特异性= 1;诊断结节病的灵敏度= 50%，与未盲态观察者相比为83%）。第二位经验较少的蒙面观察者在10名患者中的3名和27名对照中的3名中检测到MGCs（对照组的11.1%）（p = 0.186;特异性= 0.89;敏感性=所有结节病患者的30%，与未设盲观察者相比为50%）。利用IVCM显示结膜结节病的基本组织学和病理学是一种新方法。初步结果表明，训练有素的观察员可以检测肉芽肿性炎症中的MGCs。与Confoscan 3相比，ASL-1000显微镜往往具有更好的分辨率和更深的结膜穿透。
Aim: To explore the use of in-vivo confocal microscopy (IVCM) as a potential non-invasive adjunctive tool for diagnosing sarcoidosis.Methods: Conjunctivae were imaged using confocal microscopy in 10 patients with sarcoidosis and 27 control subjects. We utilized the ASL-1000 Scanning Confocal Microscope (Advanced Scanning Ltd., New Orleans, LA) and the Confoscan 3 (Nidek Co. Ltd., Gamagori, Japan). Two masked observers reviewed the in-vivo confocal images of the conjunctivae in these subjects. One masked observer was experienced in reviewing confocal images. The most striking and obvious feature seen in granulomatous inflammation on confocal microscopy is the presence of multinucleated giant cells (MGCs).Results: Unmasked observation of the scans revealed MGCs in six of the 10 sarcoid patients and no MGCs in the controls. One experienced masked observer found MGCs in five of the 10 patients with sarcoidosis and had no false-positive results (Fisher's exact test, p = 0.001; specificity = 1; sensitivity = 50% for the diagnosis of sarcoidosis and 83% compared to the unmasked observer). The second less-experienced masked observer detected MGCs in three of the 10 patients and three of the 27 controls (11.1% of the controls) (p = 0.186; specificity = 0.89; sensitivity = 30% of all patients with sarcoidosis and 50% compared to the unmasked observer).Conclusions: The utilization of IVCM to visualize the basic histology and pathology in sarcoidosis of the conjunctiva is novel. Initial results indicate that trained observers can detect MGCs in granulomatous inflammation. The ASL-1000 microscope tends to have better resolution and deeper penetration of the conjunctiva compared with the Confoscan 3.